New research on the global prevalence of female genital mutilation/cutting: Research, clinical, and policy implications
Authors: Kerrie Stevenson, Brenda Kelly
Journal: PLoS Medicine (2022)

Female genital mutilation or cutting (FGM/C) involves the partial or total removal of external female genitalia including other injuries to the female genital organs for nonmedical reasons [1].The practice is considered a violation of a child's human right to bodily integrity, a form of gender-based violence (GBV), and can result in severe health complications resulting in significant healthcare costs [2][3][4].The United Nations Sustainable Development Goal (SDG) 5.3 calls for an end to the practice; however, one of the challenges in charting progress relates to establishing accurate baseline prevalence data within countries and regions [5].In a recently published PLOS Medicine article, Farouki and colleagues present a global systematic review estimating the prevalence of FGM/C among women and girls [1,6,7].The review includes 397,683 women across 28 countries, and 283,437 girls across 23 countries.Farouki and colleagues derive a global estimate of approximately 100 million women and girls affected, which is on the lower bound of previously published estimates, which range between 100 and 200 million [1,6,7].This may be because some previous estimates included household-level prevalence studies that may not be nationally representative.The most common type of FGM/C among women was "flesh removed" (Type I or II) in 19 countries, and "not sewn closed" (Type I, II, or IV) among girls in 9 countries.The overall pooled prevalence of FGM/C among women aged 15 to 49 years was 38.3% (95% CI: 20.8% to 59.5%; PI: 0.48% to 98.8%) and 7.25% (95% CI: 3.1% to 16.0%; PI: 0.1% to 88.9%) among girls aged 0 to14 years.The prevalence among 0-to 14-year-old girls is likely underreported as they are still at risk at the point of surveying.Regardless, these data and others suggest the practice is less common in younger generations perhaps due to changing attitudes within communities in high-prevalence countries [8].While FGM/C decreased for women and girls in 23 and 25 countries, respectively, some increases were reported in countries including Somalia, Burkina Faso, and Guinea-Bissau.While this review advances our understanding of the global landscape of FGM/C, there are limitations to keep to in mind.One limitation stems from a lack of contextually valid survey tools for data relating to type of FGM/C.This may impact women and girls' ability to identify the form of FGM/C performed.Additionally, women and girls may not be able to accurately recall which procedure was performed.The search strategy did not include labial elongation, which is another form of genital alteration often considered under Type IV FGM (defined as all other harmful procedures to the female genitalia for nonmedical purposes), but which does not involve flesh cutting, rAU : Anabbreviationlisthasbeencompiledforthoseusedthroughoutthetext:Pleas emoval, or circumcision [9].This is practised in eastern and southern Africa, including Uganda, Rwanda, Zambia, Zimbabwe, and Mozambique [9].Although WHO removed labial elongation from Type IV definition in the 2008 typology, the